FDA Approval Summary: Atezolizumab and Durvalumab in Combination with Platinum-Based Chemotherapy in Extensive Stage Small Cell Lung Cancer
Autor: | Xiaoxue Li, Pallavi S. Mishra-Kalyani, Sujay Shah, Erin Larkins, Jonathon Vallejo, Lisa Rodriguez, Luckson Mathieu, Lee Pai-Scherf, Kirsten B. Goldberg, Julia A. Beaver, Richard Pazdur, Paul G. Kluetz, Harpreet Singh, Marc R. Theoret |
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Rok vydání: | 2021 |
Předmět: |
0301 basic medicine
Oncology Cancer Research medicine.medical_specialty Durvalumab Lung Neoplasms medicine.medical_treatment Antibodies Monoclonal Humanized law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Randomized controlled trial Atezolizumab law Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Etoposide Regulatory Issues: FDA Platinum Cisplatin Chemotherapy business.industry United States Food and Drug Administration Hazard ratio Antibodies Monoclonal Small Cell Lung Carcinoma Carboplatin United States 030104 developmental biology chemistry 030220 oncology & carcinogenesis business medicine.drug |
Zdroj: | Oncologist |
ISSN: | 1549-490X |
Popis: | The U.S. Food and Drug Administration (FDA) granted approval to atezolizumab and durvalumab in March of 2019 and 2020, respectively, for use in combination with chemotherapy for first-line treatment of patients with extensive stage small cell lung cancer. These approvals were based on data from two randomized controlled trials, IMpower133 (atezolizumab) and CASPIAN (durvalumab). Both trials demonstrated an improvement in overall survival (OS) with anti–programmed death ligand 1 antibodies when added to platinum-based chemotherapy as compared with chemotherapy alone. In IMpower133, patients receiving atezolizumab with etoposide and carboplatin demonstrated improved OS (hazard ratio [HR], 0.70; 95% confidence interval [CI], 0.54–0.91; p = .0069), with median OS of 12.3 months compared with 10.3 months in patients receiving etoposide and carboplatin. In CASPIAN, patients receiving durvalumab with etoposide and either cisplatin or carboplatin also demonstrated improved OS (HR, 0.73; 95% CI, 0.59–0.91; p = .0047) with median OS of 13.0 months compared with 10.3 months in patients receiving etoposide and either cisplatin or carboplatin. The safety profiles of both drugs were generally consistent with known toxicities of immune-checkpoint inhibitor therapies. This review summarizes the FDA perspective and data supporting the approval of these two agents. Implications for Practice Effective therapeutic options for small cell lung cancer (SCLC) are limited, and there has been modest improvement in the overall survival (OS) of patients with SCLC over the past 3 decades. The approvals of atezolizumab and of durvalumab in combination with chemotherapy for first-line treatment of patients with extensive stage SCLC represent the first approved therapies with OS benefit for this patient population since the approval of etoposide in combination with other approved chemotherapeutic agents. Additionally, the efficacy results from IMpower133 and CASPIAN lay the groundwork for possible further evaluation in other treatment settings in this disease. |
Databáze: | OpenAIRE |
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